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분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발- 파일 없음
2015-03-19 10:04:00

분만성 상완 신경총 손상, 선천성근성사경 및 구개열의 병발


아주대학교 의과대학 사경치료센터 ¹재활의학교실, ²성형외과학교실




Concurrence of Obstetric Brachial Plexus Injury, Congenital Muscular Torticollis and Cleft Palate


Han Byul Lee¹, Myong Chul Park², Cheesun Kim², Jae Deok Han¹,
Seung Jae Lee¹, Se Yon Kim¹ and Shin-Young Yim¹


¹ The Center for Torticollis, Department of Physical Medicine and Rehabilitation
² Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea


A male infant was diagnosed with obstetric brachial plexus injury, congenital muscular torticollis and cleft palate 17 days after birth. His mother presented with gestational diabetes and premature rupture of membranes. Although it is possible that these three disorders arose independently, it is very likely that all three have the same etiologic cause, and we propose that a possible mechanism for this concurrence is related to maternal gestational diabetes. Maternal hyperglycemia mostly affects fetal structures deriving from the neural crest, including the palatine bone, and may have caused the cleft palate observed in this case. Gestational diabetes is also associated with increased frequency of large for gestational age infants and, by extension, with increased risk of birth injuries such as obstetric brachial plexus injury or congenital muscular torticollis associated with large for gestational age infants. Since the children of mothers with gestational diabetes are at increased risk for congenital defects such as cleft palate as well as being large for gestational age, precautions indicated for each respective disorder must be taken during prenatal testing and during birth. However, further studies of more cases are required to evaluate whether the concurrence of obstetric brachial plexus injury, congenital muscular torticollis and cleft palate in this case are complications specifically associated with gestational diabetes or just a simple coincidence.


Key Words: Brachial plexus, Torticollis, Cleft palate, Gestational diabetes



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